We carried out an unannounced inspection on the 7th January 2015. The last inspection took place on 11 July 2013 and there was no evidence of any regulatory breaches.
Veedale is registered to provide care for up to 18 young adults who have a learning disability. The home was providing care and accommodation for people with nursing and personal care needs. The registration requirements for the provider stated the home should have a registered manager in place. There was a registered manager in post on the day of our inspection.
A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.
Systems to ensure people who used the service received safe effective care were in place. This was because the provider ensured people had access to specialist input in the planning and delivering of their care. We noted in people’s care files evidence of reviews undertaken by professionals. We saw some doors that should have remained locked were not always secured. This meant there was a risk of people who needed high levels of supervision accessing external areas unobserved.
Duty rotas for each of the units in the home identified appropriate cover in place. Gaps due to sickness were seen to be covered by the home’s own staff team. Staffing levels were determined according to the layout of the building and people’s needs.
We discussed the arrangements in place to manage people’s medicines safely and effectively. Staff confirmed they received medication training and we saw evidence of training recorded on the training matrix in the home. Policies and national guidance were in place to offer guidance and support when dealing with medications in the home. There were some gaps in medicine records.
People told us they enjoyed the meals and choices were on offer. People were observed to have access to drinks at all times during our inspection. We observed the menu choices for the day and the cook told us menus were picked daily by people who used the service and that people would be able to have a meal of their choice if they did not want what was on offer.
Arrangements to ensure people who used the service were cared for by an appropriately trained staff team were in place. This was because the provider had evidence of staff training, including a training schedule in place for the staff team. Topics covered in the training included, fire safety, first aid, moving and handling, health and safety, drugs administration, safe swallowing, epilepsy, autism, intensive interaction and learning disability communication awareness.
Staff we spoke with were able to provide evidence of an understanding of the Mental Capacity Act (MCA 2005) and Deprivation of Liberty Safeguards) DoLS and the appropriate procedure they would take if a person using the service was being deprived of their liberty unlawfully.
We observed people who used the service during activities. We noted staff asked people if they were happy to take part in the session prior to commencing and we noted appropriate equipment and protective clothing was applied.
We observed range of activities the provider offered on the day of our inspection. The registered manager told us the provider had a team of lifestyle staff who were dedicated to activities in the home. The leader in the lifestyle team told us, “We have developed a bespoke day care activity service.
All care files were individualised and reflected people’s current needs including a description of the person’s current health state. We noted care plans and risk assessments were in place and these had been evaluated recently and regularly. Specific needs such as, moving and handling, challenging behaviour, strategies to cope, medication and dietary advice were in place.
We asked the registered manager about how the provider dealt with complaints in the service. We were told, “We have the complaints policy at the front door and a complaints form with actions and time period to deal with them.”
We asked if the home received feedback from staff, people who used the service or their relatives. We were told the provider sent out a dignity questionnaire to all staff and fed back the results about what we are good at and where we need to improve.
Staff we spoke with in the home were positive about the support they received for the management at the home. We were told, “The manager is brilliant and approachable nothing is too big or small for her.”
We saw evidence of staff meetings taking place. Topics discussed were seen including actions, attendees and the aims of the meetings. The registered manager told us they were driving up quality by developing a staff and relative meeting to discuss how improvements can be made in the home.
We saw evidence of audits and monitoring taking place in the home for example, there was a copy of an inspection audit that had taken place recently which detailed care plans and risk assessment audits that had been completed as well as reference to any concerns or complaints that had been received.